An early outbreak of influenza has prompted the Alabama Department of Public Health to urge high-risk individuals to seek flu shots as soon as they can.

"I urge Alabamians who are at high risk form influenza to get the flu shot," said Dr. Donald Williamson, state health officer. "This outbreak is much earlier than usual and it may mean that the flu season will be more severe than average."

Several groups of people should obtain flu shots because they are at high risk of complications, such as pneumonia or even death. These groups include persons 65 years old or older; residents of nursing homes and other long-term care facilities that house persons of any age who have long-term illnesses; adults and children who have chronic heart or lung conditions, including asthma; adults and children who need regular medical care or have been in a hospital because of diseases like diabetes, chronic kidney disease, or weakened immune system; women who will be more than 3 months pregnant during the flu season, children

6-23 months of age and household contacts of high-risk people.

October and November are the recommended times for flu shots. Shots are available from private physicians, clinics, public health clinics and pharmacies.

"Folks need to seek flu shots immediately," Director of the Immunization Division of the Alabama Department of Public Health Winkler Sims said. "The combination of the early appearance of outbreaks and the subtype of influenza suggest that we will experience a severe flu season."

In mid-October, up to half of the students were absent from one school in Blount County. Through cooperation with the local hospital and physicians, samples were taken and sent to the state public health laboratory. Influenza type A was confirmed by culture.

Normally, influenza does not cause outbreaks in Alabama until December, at the earliest. Texas has been experiencing widespread influenza activity and other states, including Alabama, are having cases of flu.

"A number of states reported broad activity (from the virus)," ADPH representative Richard Holmes said. "The flu has been reported at least once in 48 states already."

Flu can affect a broad scope of individuals, and flu viruses can lead to other illnesses, according to Holmes.

"The virus is primarily recommended for those at-risk," he said. "There has been a national increase in the number of pneumonia-related deaths, and the flu has been associated with that illness."

Holmes added the vaccinations for flu are tailored to protect an individual from the virus, but he said the way the department tracks and studies the virus is not common among other diseases.

"We don't collect case-by-case statistics (for the virus)," he said. "We set up sites at private locations. When practices see an increase in the number of cases, we help them submit specimens to determine circulation in the community. We also check a number of elementary schools to see if absenteeism rates are higher than usual."

Laboratory tests showed the first outbreak this year was due to type A influenza. Although the flu viruses from Blount County have not been subtyped, all the flu viruses found in the rest of the nation have been a certain subtype of flu A. This subtype is more likely to cause those at high risk to develop complications, including death.

Flu is caused by a virus. In an average year, 20 percent of the population experiences influenza. Symptoms include the sudden onset of fever, often in the 102-104 degree Fahrenheit range, headache, body aches, mild sore throat, stuffy nose, and the beginning of a cough. Severe symptoms last two to seven days but the cough can last for weeks. Some patients become so sick they need hospitalization and some even die.

Most of these severe complications occur among high-risk people. In a severe year, 720 Alabamians die and over 2,000 are hospitalized as a result of the flu.